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These gaps include information on body part injured and age-specific risk factors. Attendees concluded that the evaluation of proposed intervention strategies would likely be hampered by knowledge gaps that result in an incomplete understanding of playground-related injuries. In an editorial, MacKay presented results from a meeting of world experts on playground injuries that included a discussion on the current state of research and existing gaps in knowledge (MacKay, 2003). These studies varied in terms of the age range of the study population and none looked in detail at other mechanisms. Studies focused on playground-related injuries, including those involving slides, have found that the major mechanism of injury was a fall (Vollman et al., 2009 Bae et al., 2017 Bernardo et al., 2001 Mayr et al., 1995 Petridou et al., 2002).
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In Korea, slides accounted for the highest percentage of playground equipment-related injuries resulting in ED visits (40.5%) and hospitalizations (33.9%) (Bae et al., 2017). Over one-fifth of all ED visits for US playground-related injuries are due to slides, and 4.5% of these have required hospitalization (Loder, 2008 Vollman et al., 2009). Slides are a popular playground and backyard apparatus (Nixon et al., 2003), and have been a major contributor to playground equipment-related injuries (Purvis and Hirsch, 2001 Fuselli and Yanchar, 2012). Unfortunately, they also pose a significant risk of injury (Mack et al., 2000 Norton et al., 2004). In fact, playground equipment has become a cornerstone of elementary schools, daycare centers, public parks, apartment building play areas, and the backyards of many homes. They are a place where children not only exercise and develop their gross motor skills, but also interact with other children to acquire social skills (Frost et al., 2004 Tremblay et al., 2015). Playgrounds play an integral role in the lives of most young children and parents in developed countries. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0–58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7–77.4). Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person’s lap at the time of injury. Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3–5 years of age ( p < 0.001). The most frequent diagnosis was a fracture (36%) lacerations were 19% of the injuries. Almost 60% of injuries occurred in parks or other public areas. Overall, 59% of the children were male, and 65% were white. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015.